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1.
  • Edvall, Niklas K., et al. (author)
  • Alterations in auditory brain stem response distinguish occasional and constant tinnitus
  • 2022
  • In: Journal of Clinical Investigation. - : American Society for Clinical Investigation. - 0021-9738 .- 1558-8238. ; 132:5
  • Journal article (peer-reviewed)abstract
    • BACKGROUND. The heterogeneity of tinnitus is thought to underlie the lack of objective diagnostic measures.METHODS. Longitudinal data from 20,349 participants of the Swedish Longitudinal Occupational Survey of Health (SLOSH) cohort from 2008 to 2018 were used to understand the dynamics of transition between occasional and constant tinnitus. The second part of the study included electrophysiological data from 405 participants of the Swedish Tinnitus Outreach Project (STOP) cohort.RESULTS. We determined that with increasing frequency of the occasional perception of self-reported tinnitus, the odds of reporting constant tinnitus after 2 years increases from 5.62 (95% CI, 4.83–6.55) for previous tinnitus (sometimes) to 29.74 (4.82–6.55) for previous tinnitus (often). When previous tinnitus was reported to be constant, the odds of reporting it as constant after 2 years rose to 603.02 (524.74–692.98), suggesting that once transitioned to constant tinnitus, the likelihood of tinnitus to persist was much greater. Auditory brain stem responses (ABRs) from subjects reporting nontinnitus (controls), occasional tinnitus, and constant tinnitus show that wave V latency increased in constant tinnitus when compared with occasional tinnitus or nontinnitus. The ABR from occasional tinnitus was indistinguishable from that of the nontinnitus controls.CONCLUSIONS. Our results support the hypothesis that the transition from occasional to constant tinnitus is accompanied by neuronal changes in the midbrain leading to a persisting tinnitus, which is then less likely to remit.
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2.
  • Engström, Elisabet, et al. (author)
  • Auditory event-related potentials and mismatch negativity in children with hearing loss using hearing aids or cochlear implants : A three-year follow-up study
  • 2021
  • In: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 140
  • Journal article (peer-reviewed)abstract
    • Objectives: The primary aim was to examine how event-related potentials (ERPs) and mismatch negativity (MMN) change and develop over time among children with hearing loss (HL) using hearing aids (HAs) or cochlear implants (CIs). Children with normal hearing (NH) were tested as a reference group.Methods: This three-year follow-up study included 13 children with sensorineural HL (SNHL); 7 children using bilateral HAs and 6 children using CIs; and 10 children with NH as a reference group. ERPs were recorded at baseline and after three years. At time for the original study the children were approximately 5-8 years old and at the follow-up study 8-11 years old. ERP recordings and data processing were identical in both sessions. A standard stimulus alternated with five different deviants (gap, intensity, pitch, location and duration), presented in a pseudorandom sequence, thus following the multi-feature paradigm, Optimum-1. MMN was calculated from the average ERP of each deviant minus the standard stimuli. Repeated measures ANOVA was used for the statistical analyses and the results were based on samples within a specific time interval; 80-224 ms.Results: There was a statistically significant difference in the obligatory responses between the NH and HA groups at baseline, but this difference disappeared after three years in our follow-up study. The children with HA also showed a significant difference in mean ERP at baseline compared to follow-up, and significant differences between the deviants at follow-up but not at baseline. This suggests an improvement over time among the children with HAs. On the other hand, the children with CIs did not differ from the NH children at baseline, but after three years their mean ERP was significantly lower compared to both the children with HA and NH, indicating a reduced development of the central auditory system in this age span among the children with CIs. Regarding MMN, there was an interaction between the duration deviant and time for the children with HA, also indicating a possible improvement over time among the HA children.Conclusions: This three-year follow-up study shows neurophysiological differences between children with HL and children with NH. The results suggest a delay in the central auditory processing among the HA children compared to children with NH, but a possible catch-up, over time, and this potential may be worth to be utilized. Regarding the CI children, similar improvement in this age span is missing, meaning there are differences between the subgroups of children with HL, i.e. the children with HAs vs. CIs. The results highlight the importance of distinguishing between subgroups of children with HL in further research.
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  • Engström, Elisabet, et al. (author)
  • Computer-assisted reading intervention for children with hearing impairment using cochlear implants : Effects on auditory event-related potentials and mismatch negativity
  • 2020
  • In: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 137
  • Journal article (peer-reviewed)abstract
    • OBJECTIVES: The primary aim was to find out whether a computer-assisted reading intervention program with a phonic approach can affect event-related (ERPs) and mismatch negativity (MMN) in hearing impaired (HI) children using cochlear implants (CIs).METHODS: This study involved a test group of 15 HI children with CIs and a control group of 14 normal hearing (NH) children. The children were 4 years and 10 months to 8 years and 1 month old. ERPs were recorded immediately before and after 4 weeks of training with a computer-assisted reading intervention, GraphoGame. A multi-feature paradigm, Optimum-1, was used, i.e. a standard stimulus alternated with five different deviants: gap intensity, pitch, location and duration. MMN was calculated from the mean amplitude ERP of each deviant minus the standard stimulus response in a specific time interval, 80 - 224 ms. Repeated measures ANOVA was used for the statistical analysis.RESULTS: The results did not show any significant changes with the computerassisted training in the ERPs and MMNs among the HI children with CIs. The presence of both MMN and a positive mismatch response (pMMR), which might reflect an immaturity, complicates interpreting the results in this age group. Individually, there was a mix of MMNs and pMMRs among all participants, pre and post training, and the change of each deviant after intervention was not predictable.CONCLUSIONS: There are no significant changes in ERP or MMN after intervention, however lack of significances must be interpreted with caution. Besides the presence of both MMNs and pMMRs, only modest changes are to be expected on an individual basis and small samples hinder making statistical conclusions regarding the training's effects. The study contributes to some more descriptive pieces of ERPs and MMNs among the HI children with CIs. The issues of MMN and pMMR are highlighted.
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  • Engström, Elisabet, et al. (author)
  • Computer-assisted reading intervention for children with sensorineural hearing loss using hearing aids : Effects on auditory event-related potentials and mismatch negativity
  • 2019
  • In: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 117, s. 17-25
  • Journal article (peer-reviewed)abstract
    • OBJECTIVES: The primary aim was to investigate whether computer-assisted reading intervention somehow can affect event-related potentials (ERP) and mismatch negativity (MMN) in hearing impaired (HI) children with hearing aids (HAs) and normal hearing (NH) children.METHODS: The study included 15 HI children with sensorineural hearing loss (SNHL) using bilateral HAs and 14 NH children as a reference group; all children between the ages of 5 and 8. A multi-feature MMN-paradigm, Optimum-1, with a standard stimulus alternating with 5 different deviants was used. ERPs were recorded pre and post intervention, i.e. one month of repeatedly computer-assisted training (GraphoGame). MMN was calculated from the average ERP of each deviant minus standard. Data were based on samples within a specific time interval, 80-224 ms, and repeated measures ANOVA was used to analyze possible interactions.RESULTS: There was a significant difference between groups before training, though, the mean obligatory responses or MMN was not statistically significantly different before versus after training, neither among the NH nor the HI children. Further, the HI children did generally achieve lower levels in GraphoGame compared to the NH children. Altogether, our findings indicate differences between the groups and that training may affect the neurophysiological processing in the brain, gaining the HI children. Both MMN and positive mismatch response (pMMR) were seen among both the HA and NH children, irrespective to deviant type. Individually, changes of the MMN and pMMR after training seem unpredictable.CONCLUSION: There are statistically significant differences in both the obligatory responses in ERP and the MMNs between the NH and HI groups before the computer-assisted training. Though, these differences disappear after the intervention. This suggests possible training effects regarding the central auditory processing among the HI children.
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  • Kallioinen, Petter, et al. (author)
  • Semantic Processing in Deaf and Hard-of-Hearing Children : Large N400 Mismatch Effects in Brain Responses, Despite Poor Semantic Ability
  • 2016
  • In: Frontiers in Psychology. - London : Frontiers Media SA. - 1664-1078. ; 7
  • Journal article (peer-reviewed)abstract
    • Difficulties in auditory and phonological processing affect semantic processing in speech comprehension for deaf and hard-of-hearing (DHH) children. However, little is known about brain responses related to semantic processing in this group. We investigated event-related potentials (ERPs) in DHH children with cochlear implants (CIs) and/or hearing aids (HAs), and in normally hearing controls (NH). We used a semantic priming task with spoken word primes followed by picture targets. In both DHH children and controls, cortical response differences between matching and mismatching targets revealed a typical N400 effect associated with semantic processing. Children with CI had the largest mismatch response despite poor semantic abilities overall; Children with CI also had the largest ERP differentiation between mismatch types, with small effects in within-category mismatch trials (target from same category as prime) and large effects in between-category mismatch trials (where target is from a different category than prime), compared to matching trials. Children with NH and HA had similar responses to both mismatch types. While the large and differentiated ERP responses in the CI group were unexpected and should be interpreted with caution, the results could reflect less precision in semantic processing among children with CI, or a stronger reliance on predictive processing.
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7.
  • Lyxell, Björn, et al. (author)
  • Cognitive and communicative development in deaf and hearing-impaired children with cochlear implants and/or hearing-aids
  • 2011
  • Conference paper (other academic/artistic)abstract
    • The purpose of the study was to examine neurophysiological, cognitive and linguistic development in deaf and hearing-impaired children (5–7 years of age) with CI and/or hearingaids and how a phonological intervention programme may influence this development. The deaf and hearing-impaired children were compared with age-matched hearing children. The results reveal that deaf and hearing-impaired children had equivalent or close to equivalent performance levels compared to hearing children for cognitive and linguistic tasks with relatively low demands on phonological processing, whereas there was a substantial and significant difference between the groups for cognitive tasks involving explicit phonological processing. The results indicate that there is a relationship between age at implant and neurophysiological, cognitive and linguistic development, where early implantation promotes faster development. The childrens´ cognitive performance increased as a function of phonological intervention.
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  • Lyxell, Björn, et al. (author)
  • Cognitive and communicative development in deaf and hearing-impaired children with cochlear implants and/or hearing-aids
  • 2013
  • Conference paper (other academic/artistic)abstract
    • The purpose of the study was to examine neurophysiological, cognitive and linguistic development in deaf and hearing-impaired children (5–7 years of age) with CI and/or hearingaids and how a phonological intervention programme may influence this development. The deaf and hearing-impaired children were compared with age-matched hearing children. The results reveal that deaf and hearing-impaired children had equivalent or close to equivalent performance levels compared to hearing children for cognitive and linguistic tasks with relatively low demands on phonological processing, whereas there was a substantial and significant difference between the groups for cognitive tasks involving explicit phonological processing. The results indicate that there is a relationship between age at implant and neurophysiological, cognitive and linguistic development, where early implantation promotes faster development. The childrens´ cognitive performance increased as a function of phonological intervention.
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  • Mackey, Allison R., et al. (author)
  • Protocol and programme factors associated with referral and loss to follow-up from newborn hearing screening : a systematic review
  • 2022
  • In: BMC Pediatrics. - : BioMed Central (BMC). - 1471-2431. ; 22:1
  • Research review (peer-reviewed)abstract
    • BACKGROUND: An effective newborn hearing screening programme has low referral rate and low loss to follow-up (LTFU) rate after referral from initial screening. This systematic review identified studies evaluating the effect of protocol and programme factors on these two outcomes, including the screening method used and the infant group.METHODS: Five databases were searched (latest: April 2021). Included studies reported original data from newborn hearing screening and described the target outcomes against a protocol or programme level factor. Studies were excluded if results were only available for one risk condition, for each ear, or for < 100 infants, or if methodological bias was observed. Included studies were evaluated for quality across three domains: sample, screening and outcome, using modified criteria from the Ottawa-Newcastle and QUADAS-2 scales. Findings from the included studies were synthesised in tables, figures and text.RESULTS: Fifty-eight studies reported on referral rate, 8 on LTFU rate, and 35 on both. Only 15 studies defined LTFU. Substantial diversity in referral and LTFU rate was observed across studies. Twelve of fourteen studies that evaluated screening method showed lower referral rates with aABR compared to TEOAE for well babies (WB). Rescreening before hospital discharge and screening after 3 days of age reduced referral rates. Studies investigating LTFU reported lower rates for programmes that had audiologist involvement, did not require fees for step 2, were embedded in a larger regional or national programme, and scheduled follow-up in a location accessible to the families. In programmes with low overall LTFU, higher LTFU was observed for infants from the NICU compared to WB.CONCLUSION: Although poor reporting and exclusion of non-English articles may limit the generalisability from this review, key influential factors for referral and LTFU rates were identified. Including aABR in WB screening can effectively reduce referral rates, but it is not the only solution. The reported referral and LTFU rates vary largely across studies, implying the contribution of several parameters identified in this review and the context in which the programme is performed. Extra attention should be paid to infants with higher risk for hearing impairment to ensure their return to follow-up.
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15.
  • Nakeva von Mentzer, Cecilia, et al. (author)
  • Computer-assisted intervention for children with hearing impairment : Cognitive factors and phonological change
  • 2013
  • In: CHSCOM2013. - : Linköping University Electronic Press.
  • Conference paper (other academic/artistic)abstract
    • Thirty-two children with hearing impairment (HI) using cochlear implants (CI) and/or hearing aids (HA), and sixteen with normal hearing (NH) participated in a computer-assisted intervention study that focused on perceiving and memorizing phonemic sounds. The first purpose was to study cognitive abilities in NH and HI children, how they related to phonological processing skills (PhPS) pre intervention and to phonological growth post intervention. The second purpose was to analyze children’s performance at different fine-grained levels of phonological processing, i.e. how they manipulated, stored and produced phonological entities of different size with or without semantic content. This was put in relation to children’s type of auditory stimulation (electrical; bilateral CI, bimodal: CI + HA and acoustical; bilateral HA). Results showed significant correlations between complex working memory and PhPS in children with HI but not in children with NH. This suggests different cognitive strategies in the children when dealing with phonological processing tasks. Poor phoneme discrimination was the strongest predictor of phonological growth in the children with HI as a function of training. Thus, the computer-assisted program was beneficial for HI children with weak initial phoneme discrimination skills. Children with CI showed reduced performance at fine-grained levels of receptive phonological processing but not on expressive phonological lexical tasks.
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16.
  • Nakeva von Mentzer, Cecilia, et al. (author)
  • Computer-assisted intervention for Deaf and Hard of hearing (D/HH) children with cochlear implants or hearing aids : Cognitive factors and phonological change
  • 2013
  • Conference paper (other academic/artistic)abstract
    • Aim: Study cognitive abilities; specifically working memory and lexical access in NH and DHH children, and their correlations to phonological processing skills (PhPS) pre intervention. Analyze how cognitive abilities related to phonological change post intervention. Material and Method: Tasks for lexical access, complex and visual working memory and Phpr were assessed pre and post intervention.Conclusion: DHH children performed at a lower level than NH children on lexical access but equally on complex and visual working memory. Significant correlations between complex working memory and PhPS were evident in DHH children but not in NH. This suggests that DHH children recruit more cognitive resources when performing PhPr tasks. Weak initial performance on a task for phonological representations (Phrep) was the only significant predictor of phonological change in DHH children. Weak PhRep was associated with a higher age at diagnosis, higher age at implant, and shorter usage-time with CI. 
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17.
  • Nakeva von Mentzer, Cecilia, et al. (author)
  • Computer-assisted reading intervention with a phonics approach for children using cochlear implants or hearing aids
  • 2014
  • In: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 55:5, s. 448-455
  • Journal article (peer-reviewed)abstract
    • The present study examined computer-assisted reading intervention with a phonics approach for deaf and hard of hearing (DHH) children in Sweden using cochlear implants or hearing aids, or a combination of both. The study included 48 children, 5, 6 and 7years of age. Sixteen children with normal hearing (NH) served as a reference group. The first purpose of the study was to compare NH and DHH children's reading ability at pre and post-intervention. The second purpose was to investigate effects of the intervention. Cognitive and demographic factors were analyzed in relation to reading improvement. Results showed no statistically significant difference for reading ability at the group level, although NH children showed overall higher reading scores at both test points. Age comparisons revealed a statistically significant higher reading ability in the NH 7-year-olds compared to the DHH 7-year-olds. The intervention proved successful for word decoding accuracy, passage comprehension and as a reduction of nonword decoding errors in both NH and DHH children. Reading improvement was associated with complex working memory and phonological processing skills in NH children. Correspondent associations were observed with visual working memory and letter knowledge in the DHH children. Age was the only demographic factor that was significantly correlated with reading improvement. The results suggest that DHH children's beginning reading may be influenced by visual strategies that might explain the reading delay in the older children.
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18.
  • Nakeva von Mentzer, Cecilia, 1968-, et al. (author)
  • Computer-assisted training of phoneme-grapheme correspondence for children who are deaf and hard of hearing : Effects on phonological processing skills
  • 2013
  • In: International Journal of Pediatric Otorhinolaryngology. - Amsterdam, Netherlands : Elsevier. - 0165-5876 .- 1872-8464. ; 77:12, s. 2049-2057
  • Journal article (peer-reviewed)abstract
    • Objective: Examine deaf and hard of hearing (DHH) children's phonological processing skills in relation to a reference group of children with normal hearing (NH) at two baselines pre intervention. Study the effects of computer-assisted phoneme-grapheme correspondence training in the children. Specifically analyze possible effects on DHH children's phonological processing skills.Methods: The study included 48 children who participated in a computer-assisted intervention study, which focuses on phoneme-grapheme correspondence. Children were 5, 6, and 7 years of age. There were 32 DHH children using cochlear implants (CI) or hearing aids (HA), or both in combination, and 16 children with NH. The study had a quasi-experimental design with three test occasions separated in time by four weeks; baseline 1 and 2 pre intervention, and 3 post intervention. Children performed tasks measuring lexical access, phonological processing, and letter knowledge. All children were asked to practice ten minutes per day at home supported by their parents.Results: NH children outperformed DHH children on the majority of tasks. All children improved their accuracy in phoneme-grapheme correspondence and output phonology as a function of the computer-assisted intervention. For the whole group of children, and specifically for children with CI, a lower initial phonological composite score was associated with a larger phonological change between baseline 2 and post intervention. Finally, 18 DHH children, whereof 11 children with CI, showed specific intervention effects on their phonological processing skills, and strong effect sizes for their improved accuracy of phoneme-grapheme correspondence.Conclusion: For some DHH children phonological processing skills are boosted relatively more by phoneme-grapheme correspondence training. This reflects the reciprocal relationship between phonological change and exposure to and manipulations of letters.
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  • Nakeva von Mentzer, Cecilia, et al. (author)
  • Coputer based phonological intervention : Effects on phonological processing
  • 2012
  • Conference paper (peer-reviewed)abstract
    • Children with mild to profound hearing impairment (HI) using cochlear implants (CI) and/or hearingaids (HA), and children with normal hearing (NH) participated in a phonological intervention study, bymeans of a computer‐based intervention program (Graphogame, Lyytinen et al., 2009). Children were 5,6 and 7 years of age. Thirty‐two of the children used CI and/or HA. 16 children with NH served as thecontrol group. The main design was a quasi‐experimental 3 x 3 design. Each test session was separatedin time with four weeks. All children were asked to practice 10 minutes per day at home supported bytheir parents, with an intervention program primarily developed to enhance phonemic differentiation.Results showed that the children with HI displayed a heterogeneous pattern of results, specifically withrespect to their performance on the phonological tasks. Approximately 20 percent performed within therange of NH children; these were all children with HA except one child with CI/HA. Children with CIdisplayed considerable difficulty with phonological working memory whereas children with HAshowed less knowledge in letter tasks. Intervention revealed positive effects on accuracy of phonemegraphemecorrespondence for all children and a significant positive change on phonological processingskills for children with weak initial phonological skills. Enhanced phoneme‐grapheme connections maybuild associations between the phonological lexicon and the sub‐lexical phonological representations,thereby improving underlying skills essential for word learning and the development of literacy. Implicationsof this are discussed within theoretical models of phonological and lexical processing (Goswami,2000; Ramus, 2001).
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21.
  • Nakeva von Mentzer, Cecilia, 1968-, et al. (author)
  • Datorbaserad fonologisk intervention för barn med cochleaimplantat (CI) och/eller hörapparat (HA) : effekter på fonologiska färdigheter
  • 2012
  • In: Logopednytt. - Stockholm, Sweden : Svenska Logopedförbundet (SLOF). - 1102-500X. ; :3, s. 18-23
  • Journal article (other academic/artistic)abstract
    • Children with mild to profound hearing impairment 5, 6 and 7 years of age, thirty-two using cochlear implants and/or hearing aids, and sixteen normal hearing children participated in a computer based phonological intervention study.The main design was a quasi-experimental design with three test sessions separated in time with four weeks. Each test session included tasks for phonological skills and letter knowledge. All children were asked to practice 10 minutes per day.Results showed that children with HI displayed a heterogeneous pattern of results with respect to phonological skills. Only 20 percent performed within the range of NH children; these were children with HA, except one child with CI/HA.Group comparisons at the first and last test session revealed that children with CI displayed difficulty with phonological working memory whereas children with HA showed less letter knowledge. Intervention revealed positive effects on accuracy of phoneme-grapheme correspondence for all children and a significant positive change on phonological processing skills for children with weak initial phonological skills.
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